As the state grapples with a $3.5 billion budget deficit, we must not lose sight of slowly acquired gains, those that require continued investment now before they pay off in the future. If we don't, the dollars the state might think it is saving now will be lost later when we have to spend more as we try to undo trauma-based harm to our state's future workforce.
This presents a crucial intersection of social and economic policy that should not be overlooked. In a bare-bones fiscal era, we need to find a way to protect what the Alaska Mental Health Board's Pat Sidmore calls "an infrastructure investment in people."
Sidmore, who works for the board as a health and social services planner, conducted an analysis for the Mental Health Board and Alaska's Advisory Board on Alcoholism and Drug Abuse that shows if childhood trauma were modestly reduced in Alaska, the state could save nearly $92 million each year in costs related to the long-term impacts trauma has on overall health and success. Eliminating child abuse could lead to an immediate additional savings of $82 million each year. The state spends $48,375 on every child for whom there is a substantiated report of harm. Reduce the harm, reduce the cost.
Data show that Alaska's investment in child welfare is already leading to gains. When Sidmore compared childhood trauma rates of Alaskans to those of several other states, he found that Alaskans had a higher rate of childhood trauma. But when he isolated the data by age sets, younger Alaskans reported fewer traumatic experiences than older Alaskans, and the younger Alaskans' rates more closely aligned with rates seen in other states. It was the older Alaskans, those who would not have had early intervention offered to younger generations, who showed the greatest amount of trauma early in life.
The Alaska Department of Education and Early Childhood Development has in recent years provided four programs for the pre-K age group. But in Gov. Bill Walker's proposed budget for 2017, three of the programs are stripped of their funding, said Anji Gallanos, early childhood administrator and pre-K-fifth grade content specialist for the department.
Parents as Teachers, which served 143 children and 123 families, may lose its $500,000 annual budget. The national home visitation program served families in Juneau, Homer, Anchorage and Tok, regardless of income. Hundreds of 4-year-olds enrolled in the department's preschool programs may lose out on social and emotional developmental screenings, as the $2 million to administer them has been cut for 2017. Finally, Best Beginnings, a $320,000-per-year program that provides books to children and young families, in addition to supporting parenting skills and school readiness, has also been cut. What remains for 2017 is $7 million in state spending for 16 "Head Start" programs across the state that serve about 3,500 children from birth to the age of 4.
A request for information about trauma intervention and early childhood wellness programs currently in place through the Department of Health and Human Services was not returned in time for publication. The department does offer services aimed at preventing childhood trauma and stabilizing families, like its Nurse and Family Partnership Program, infant learning program (for newborns up to 3-year-olds with disabilities) and its Strengthening Families initiative.
It's easy to think about childhood trauma as a distant, abstract problem -- the "not me" or "not in my family" illusion. But it can take a variety of forms: physical, verbal, or sexual abuse; living with someone who suffers from substance abuse or mental illness; witnessing domestic violence; having parents who are separated or divorced; having a parent or family member who is in jail.
"It is around us everywhere. It's our friends, our neighbors, our co-workers, our family. For two thirds of us (Alaskans), it's us, too," Sidmore said.
"The impact of investments provided from state coffers in preventing and mitigating the results of (childhood trauma) must not be lost as budgets are cut. To lose ground leads not only to increased future costs, but given the new reality, most likely decreased future revenues as well. Alaskans with (more instances of childhood trauma) make less money, are less likely to own their own homes and are more likely to be unable to work," Sidmore writes in his report: "Economic Costs of Adverse Childhood Experiences in Alaska: The Price of Not Intervening Before Trauma Occurs."
The report illustrates the tangible financial value of protecting and nurturing our youngest citizens. If Alaska does not tenaciously do so, it risks widening the future productivity gap among Alaskans. The state is also signing up to take on increased expenses years down the road in the areas of health care, prisons, welfare, special education, mental health, drug and alcohol addiction and foster care, to name only a few.
Nobel laureate James Heckman, an economist at the University of Chicago, makes this case when he talks about the economics of human potential. Simply put, investing in disadvantaged children pays huge dividends. The more stable the home, the less traumatic it is, the greater access to early education that children have, the more likely they are to grow into functional adults who contribute to society. Few things offer the rate of return that giving children a healthy start does.
Heckman has calculated that society can recoup a 10 percent rate of return on money invested in very young people. He says the more capable people are as adults, the more a community reduces inequality and increases productivity. And Sidmore, who references Heckman's work, notes the rate of return is an annual one. Ten percent per year per person. The dividends comes in tax revenue, but is also delivered through savings on state services.
Eliminating all childhood trauma is unrealistic. But reducing it is achievable, with investment in programs and supports that work. This intervention must start young, from conception to at least age 5, when the brain is wiring itself for the future. And from Heckman's view, the best programs not only target this young age window, but also involve support for and engagement of parents, and have measurable results.
Alaska's professionals do a lot of good work trying to undo the damage of early childhood trauma. But the older someone gets, the more difficult it becomes. Prevention and early intervention are key, both for building the greatest resilience and in terms of overall cost savings.
A test in 1970 called the Stanford Marshmallow Experiment sought to measure impulse control in children and compare the outcomes to how well the children did later in life. Children were given one marshmallow they could eat right away. Or, if they waited, they could have two marshmallows. Follow-up studies showed that the children who could wait had better life outcomes: better health, better educational achievement, better test scores on college readiness exams.
Here's hoping the Legislature, on behalf of Alaskans, waits for the second marshmallow.
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